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19 August 2017 Impairment of cerebral autoregulation in pediatric extracorporeal membrane oxygenation associated with neuroimaging abnormalities
Fenghua Tian, Michael Craig Morriss, Lina Chalak, Ramgopal Venkataraman, Chul Ahn, Hanli Liu, Lakshmi Raman
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Neurophotonics, Vol. 4, Issue 4, 041410 (August 2017). https://doi.org/10.1117/1.NPh.4.4.041410
Abstract
Extracorporeal membrane oxygenation (ECMO) is a life-supporting therapy for critically ill patients with severe respiratory and/or cardiovascular failure. Cerebrovascular impairment can result in hemorrhagic and ischemic complications commonly seen in the patients supported on ECMO. We investigated the degree of cerebral autoregulation impairment during ECMO as well as whether it is predictive of neuroimaging abnormalities. Spontaneous fluctuations of mean arterial pressure (MAP) and cerebral tissue oxygen saturation (SctO2) were continuously measured during the ECMO run. The dynamic relationship between the MAP and SctO2 fluctuations was assessed based on wavelet transform coherence (WTC). Neuroimaging was conducted during and/or after ECMO as standard of care, and the abnormalities were evaluated based on a scoring system that had been previously validated among ECMO patients. Of the 25 patients, 8 (32%) had normal neuroimaging, 7 (28%) had mild to moderate neuroimaging abnormalities, and the other 10 (40%) had severe neuroimaging abnormalities. The degrees of cerebral autoregulation impairment quantified based on WTC showed significant correlations with the neuroimaging scores (R=0.66; p<0.0001). Evidence that cerebral autoregulation impairment during ECMO was related to the patients’ neurological outcomes was provided.
CC BY: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.
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Fenghua Tian, Michael Craig Morriss, Lina Chalak, Ramgopal Venkataraman, Chul Ahn, Hanli Liu, and Lakshmi Raman "Impairment of cerebral autoregulation in pediatric extracorporeal membrane oxygenation associated with neuroimaging abnormalities," Neurophotonics 4(4), 041410 (19 August 2017). https://doi.org/10.1117/1.NPh.4.4.041410
Received: 24 March 2017; Accepted: 24 July 2017; Published: 19 August 2017
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Cited by 23 scholarly publications.
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KEYWORDS
Neuroimaging
Magnetic resonance imaging
Brain mapping
Neurophotonics
Ultrasonography
Wavelets
Blood
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